Method for the x-ray visualization of body cavities and a preparation for carrying out the method

ABSTRACT

COMPOSITIONS WHICH COMPRISE AT LEAST ONE IODINE COMPOUND OF THE FORMULA:   1,3,5-TRI(I-),2-(R&#39;&#39;-NH-),4-(HOOC-),6-((2,4,6-TRI(I-),   3-(R4-NH-),5-(HOOC-)PHENYL)-N(-R3)-A-N(-R2)-)BENZENE   WHEREIN R1-R4 ARE EACH LOWER ACYL HAVING NO MORE THAN 5 CARBON ATOMS AND WHEREIN A IS AN ALKYLENE GROUP SUBSTITUTED BY AT LEAST 1 SUBSTITUENT OF THE FORMULA -O-R, WHEREIN R IS EITHER HYDROGEN, OR A LOWER ALKYL OR ACYL HAVING NO MORE THAN 5 CARBON ATOMS, THE ALKYLENE GROUP CONTAINING 3-20 CARBON ATOMS, AND BEING OPTIONALLY BROKEN BY ONE OR MORE OXYGEN BRIDGES OR A PHYSIOLOGICALLY X-RAY CONTRAST COMPOSITIONS AND ARE ADMINSTERED TO THE BODY OF THE TEST OBJECT FOR THE X-RAY VISUALIZATION OF THE BODY CAVITIES.

United States Patent US. Cl. 424- 24 Claims ABSTRACT OF THE DISCLOSURE Compositions which comprise at least one iodine compound of the formula:

a, o R. R3 o 1 2, 11.1%.0 o-N-a-l to t LNJ-r 1.0 0.1 1.0 0.1

C (r0011 coon wherein R R are each lower acyl having no more than 5 carbon atoms and wherein A is an alkylene group substituted by at least 1 substituent of the formula group substituted by one or more substituents of the formula OR, wherein R is hydrogen or a lower alkyl or acyl group having no more than 5 carbon atoms, the alklene group containing 3-20 (for example 3-15) carbon atoms and being optionally broken by one or more oxygen bridges, or physiologically acceptable salts thereof. R R R and R in the aforementioned formulae are normally the same; but can also be different.

In a preferred embodiment each nitrogen atom in the bridge I IAI I is siatuated at a distance of two carbon atoms from a group of the formula OR. Preferably not more than one oxygen atom is bound to one and the same carbon atom in the bridge A. The bridge suitably contains 3l0 carbon atoms in the alkylene group.

Examples of substituents R R are acetyl, propionyl or butyryl. R is preferably selected in the form of hydrogen when hydrophilic compounds are desired. Consequently, in the majority of the fields of use R is preferably selected as a hydrogen atom. When compounds having more lipophilic properties are desired R is selected as a lower alkyl or acyl group, e.g. methyl or ethyl or acetyl or propionyl.

Examples of the bridge A in the aforementioned formulae are:

.omonyom- .omomomc OR, wherein R is either hydrogen, or a lower alkyl or acyl having no more than 5 carbon atoms, the alkylene group containing 3-20 carbon atoms, and being optionally broken by one or more oxygen bridges or a physiologically acceptable salt thereof. These compositions are useful as X-ray contrast compositions and are administered to the body of the test object for the X-ray visualization of the body cavities.

The present invention is concerned with a method for the X-ray visualization of body cavities and a preparation for carrying out the method.

The method of the invention is characterized in that there is administered to the body of the test object a preparation comprising or consisting of one or more iodo compounds of the formula wherein R R R and R are each lower acyl having no more than 5 carbon atoms and wherein A is analkylene CH3 I CH3 CH3 I CH: ('10 e c0 ('10 e co H.N.(? C.N-A-N.C C.N.H I .C /C. I I .0 Cl

r f C O OH CO OH wherein A is CH .CH (-OH) .CH .O. (CH .O.CH .CH(OH) .CH

or --CH .CH (-OH) .CH .O. (CH .O.CH .CH(OH) .CH

or any of the aforementioned bridges in which one or more hydroxyl groups have been alkylated or acylated with a lower alkyl or acyl group having no more than carbon atoms, e.g. methyl or ethyl or acetyl or propionyl, or physiologically acceptable salts thereof, e.g. sodium salts or methylglucamine salts.

A preparation for carrying out the method of the invention may suitably consist of a mixture, such as an aqueous solution, or contain a physiologically acceptable solid carrier, the preparation preferably being in tablet form or in the form of some other suitable dosage unit; said mixture containing one or more of the aforementioned compounds as active contrast-producing substances.

When applying the method of the invention the body of the test object to which the contrast-producing agent has been administered is exposed to X-rays whereupon photographs may be taken or the image observed direct on a fluorescent screen, or other X-ray technics may be applied in a conventional manner. The dose of contrastproducing agent administered is selected according to the category of the investigation, so that a suflicient contrast effect is obtained.

One example of the different body cavities which can be visibilized by the invention is the gastro-intestinal tract. In this instance, the contrast-producing agent is administered perorally in solid or solution form. The intestines can also be visibilized by administering the contrast-producing agent rectally in the form of an enema. Another example is the visualization of blood vessels subsequent to the contrast-producing agent being injected in the form of a sterile solution. When injected intravenously the contrast-producing agent is excreted with the urine and enables visibilization of the renal pelvis, ureters and bladders. Further examples are the use of the iodo compounds in hysterosalpingography, cholangiography, lymphography, urethrography and sialography.

The novel iodo compounds used according to the invention have a low toxicity, e.g. when they are administered intravenously, and present excellent characteristics as X-ray contrast-producing agents.

Carriers for the iodo compounds may be conventional additive substances, such as water with regard to injection solutions and adjuvants when in tablet form.

If the preparation of the invention is in the form, of an aqueous solution the concentration of the iodo compounds is selected in accordance with the field of use. Preferably, a content exceeding grams per 100 ml. of solution is chosen. Normally, however, an appreciably higher content is chosen, e.g. in the order of 20, 30, 40 or 50 grams or more per 100 ml. of solution.

The above described iodo compounds can be prepared, for instance, by reacting compounds of the formula wherein A has the significance as set forth above, R preferably being hydrogen, and wherein Y and X are each halogen, preferably chloro or bromo, or corresponding epoxide compounds obtainable from the compound Y.A.X. by splitting off hydrogen halide, with 1 mole of compounds of the formula H.N.C

wherein R and R have each the above significance, or

salts thereof, and with 1 mole of compounds of the formula wherein R and R have each the aforegiven significance, or salts thereof. If R is identical with R R and R which is usually the case, this means that the compound Y.A.X. is reacted with 2 moles of a compound of the formula wherein R has the above significance, or salts thereof. If R is identical with R and R with R then the compound of the formula Y.A.X. is reacted with 2 moles of a compound of the formula wherein R and R each have the above significance, or salts thereof.

Since the iodo monomers (the 3-acylamino-5-acylamino-2,4,6-triiodobenzoic acids) in this instance have two reactive hydrogen atoms, which can react with the bifunctional bridge formers which give rise to the bridges -A in the dimers, it is naturally suitable to employ, during the reactions, an excess of the iodo monomers in relation to the bridge formers to avoid formation of more highly polymerized products. The dimers obtained from the reaction products (dicarboxylic acids or salts thereof) and the monomers (monocarboxylic acids or salts thereof) can be isolated through their different solubility characteristics or by other conventional fractionating methods. The excess of iodo monomers can thus be recovered and reused in the next production step. The reactions are thus suitably conducted to avoid a higher degree of polymerization, so that it is not necessary to fractionate the dimers from products having higher polymerization degrees. Such fractionating, however, is possible with conventional fractioning methods. Monomers and possibly minor quantities of trimers etc. need not be removed from the dimers since both the monomers and the trimers etc. are acceptable.

To avoid polymerization to higher degrees of polymerization than dimers when using larger quantities of bridge formers it is possible to arrange that the iodo monomers instead of containing acylamino groups in 5-position have groups which do not contain any reactive hydrogen atom which reacts with the bridge former, said groups being converted into acylamino groups only after being dimerized with bifunctional bridge formers. However, as previously mentioned, the excess of the iodomonomers can be recovered and reused in the next batch, and consequently it is unnecessary to apply such a troublesome method.

The obtained compounds are recovered either as dicarboxylic acids or in the form of physiologically acceptable salts.

Examples of such salts are sodium salts or methylglucamine salts. Sodium and methylglucamine salts have good solubility in water.

Examples of the bifunctional compounds of the type Y.A.X. or corresponding epoxide compounds obtainable from Y.A.X. by splitting olf hydrogen halide are:

or corresponding halogen hydrins, and bifunctional glycerine derivatives of the formula X.CH .CH (OH) .CH Y,

e.g. dichlorohydrin and dibromohydrin, or corresponding epoxy compounds obtainable by splitting off hydrogen halide and having the formula e.g. epichlorohydrin and epibromohydrin. Another example of such a bifunctional compound is 1,2,3,4-diepoxybutane.

The reaction is preferably carried out in a solvent, e.g. Water or an aqueous liquid, and there is suitably added an alkaline reaction substance, e.g. alkalimetal hydroxides, the alkaline substance acting as a catalyst. Thus, the alkaline substance may also function as an acceptor for any hydrogen halide liberated during the reaction.

If it is desired to convert one or more hydroxyl groups in the bridge to alkylated or acylated hydroxyl groups the obtained compounds are treated with an alkylating agent or acylating agent, e.g. dimethylsulphate or acetic acid anhydride, in a conventional manner for alkylating or acylating hydroxyl groups.

The reaction can be carried out at different temperatures, e.g. between and 50 C., such as C.

EXAMPLE 1 0.1 mole of 3-acetylamino-5-acetylamino-2,4,6-triiodobenzoic acid was dissolved in 50 ml. of an aqueous 4 N solution of sodium hydroxide. 0.02 mole of his [2,3- epoxypropyH-ether was slowly added to the solution dropwise at 20 C. whilst stirring. The reaction mixture was then allowed to stand for 1 day at 20 C., whereafter 6 N HCl was added in an amount suflicient to precipitate the dicarboxylic acid formed in the reaction and the excess of monocarboxylic acid. The product was cleansed by 'washing with water and precipitation, and dried in vacuum at 50 C. The yield of raw product (containing dicarboxylic acid and monocarboxylic acid) was about 55-60 grams. Dicarboxylic acid was isolated from the raw product, e.g. by fractioning with methanol.

Solutions can be prepared from the resulting dicarboxylic acid by adding water and e.g. equivalent amounts of sodium hydroxide or methylglucamine.

EXAMPLE 2 0.1 mole of 3-acetylamino-5-acetylamino-Z,4,6-triiodobenzoic acid was dissolved in 50 ml. of an aqueous solution 4 N of sodium hydroxide. 0.02 mole of 1,2- ethanedioldiglycide ether was added slowly to the solution dropwise at 20C. whilst stirring. The reaction mixture was then allowed to stand for 1 day at 20 C., whereafter 6 N HCl was added in an amount sufficient to precipitate the dicarboxylic acid formed in the reaction and the excess of monocarboxylic acid. The product was cleansed by washing with water and further precipitation, and was dried in vacuum at 50 'C. The yield of the raw product (containing dicarboxylic acid and monocarboxylic acid) was about 5560 grams. The dicarboxylic acid was isolated from the raw product, e.g. by fractioning with methanol.

Solutions can be prepared from the obtained dicarboxylic acid by adding water and, e.g. equivalent quantities of sodium hydroxide or methylglucamine.

EXAMPLE 3 0.1 mole of S-acetylamino-5-acetylamino-2,4,6-triiodobenzoic acid was dissolved in 50 ml. of an aqueous 4 N solution of sodium hydroxide. 0.02 mole of 1,4- butanedioldiglycide ether was added slowly to the mixture dropwise at 20 C. whilst stirring. The reaction mixture was then allowed to stand for 1 day at 20 C. whereafter 6 N HCl was added in an amount sufficient to precipitate the dicarboxylic acid formed in the reaction and the excess of the monocarboxylie acid. The product was purified by washing and further precipitation, and was dried in vacuum at 50 C. The yield of the raw product (containing dicarboxylic acid and monocarboxylic acid) was about 55-60 grams. The dicarboxylic acid was isolated from the raw product, e.g. by fractioning with methanol.

The obtained dicarboxylic acid can be converted into salts, from which aqueous solutions can be prepared as in Example 1 and Example 2.

EXAMPLE 4 In a manner similar to that disclosed in Example 1, 0.1 mole of 3-acetylamino-S-acetylamino-Z,4,6-triiodobenzoic acid was reacted with 0.02 mole of epichlorohydrin or with 0.02 mole of epibromohydrin or with 0.02. mole of dichlorohydrin.

Cleansing of the dicarboxylic acid formed in the reaction was effected in a manner similar to that set forth in Example 1.

EXAMPLE 5 Solutions were prepared from the dicarboxylic acids obtained from each of the Examples 1, 2, 3 and 4 in the following manner: 40 grams of substance and equivalent quantities of methylglucamine were dissolved in water to a solution volume of ml. pH was adjusted to 7.3-7.4. The solution was filtered and poured into bottles, which were closed and sterilized in an autoclave.

EXAMPLE 6 The solutions from Example 5 were injected into the blood vessels of rabbits, whereupon the blood vessels could be visibilized by X-rays and photographs.

'X-ray exposure of the stomach area and subsequent photographs showed filling of the contrast-producing agent in the urinal ducts.

EXAMPLE 7 Solutions from Example 5 were administered orally to rabbits, whereafter the gastro-intestinal duct could be visibilized by X-rays and photographs with good results.

EXAMPLE 8 Solutions of sodium salt of the compound prepared in a similar manner as that disclosed in Example 5 and containing 20 grams of dicarboxylic acid per 100 ml. of solution were administered rectally to rabbits in the form of an enema, whereafter the intestines could be visibilized by X-ray and photographs with good results.

What I claim is:

1. A method for the X-ray visualization of body cavities, which comprises administering to the body of the test object as a contrast-producing agent a preparation comprising at least one member selected from the group consisting of (l) iodo compounds of the formula I I II C 0.1 LC Cl l I 00011 COOH wherein R R are each lower acyl having no more than 5 carbon atoms and wherein A is an alkylene group substituted by at least one substituent of the formula -O-R, wherein R is a member selected from the group consisting of hydrogen; lower alkyl and acyl having no more than 5 carbon atoms, said alkylene group containing 33-20 carbon atoms, and (2) physiologically acceptable salts thereof; said preparation being administered in an amount effective to give a sufficient contrast effect.

2. The method of claim 1, wherein each nitrogen atom in the bridge of the iodo compound is situated at a distance of two carbon atoms from a group OR and wherein not more than one oxygen atom is bound to one and the same carbon atom in the bridge A.

3. The method of claim 1, wherein the substituents R R in the iodo compound are each a member selected from the group consisting of acetyl; propionyl; and butyryl and R is a member selected from the group consisting of hydrogen; methyl; ethyl; acetyl; and propionyl.

4. A method for the X-ray visualization of body cavities, which comprises administering to the body of the test object as a contrast-producing agent a preparation comprising at least one member selected from the group consisting of (1) iodo compounds of the formula an :.NA-N.o min 1.81 (3.1 L 0.1 a o c do on c 0 on wherein R -R are each lower acyl having no more than 5 carbon atoms and wherein A is an alkylene group substituted by at least one substituent of the formula OR, wherein R is a member selected from the group consisting of hydrogen; lower alkyl and acyl having no more than 5 carbon atoms, said alkylene group containing 3-20 carbon atoms and being broken by at least one oxygen bridge, and (2) physiologically acceptable salts thereof; said preparation being administered in an amount effective to give a sufiicient contrast effect.

5. The method of claim 4, wherein each nitrogen atom in the bridge of the iodo compound is situated at a distance of two carbon atoms from a group OR, and wherein not more than one oxygen atom is bound to one and the same carbon atom in the bridge A.

6. The method of claim 4, wherein the substituents R -R in the iodo compound are each a member selected from the group consisting of acetyl; propionyl; and butyryl and R is a member selected from the group consisting of hydrogen; methyl; ethyl; acetyl; and propionyl.

7. The method of claim 4 wherein the bridge A in the iodo compound is a member selected from the group consisting of 8 -CH .CH(OH) .CH .O.(CH .O.CH .CH(OH) C 2; CH .CH( OH) .CH .O. CH .O.CH .CH(OH) and the aforesaid bridges in which at least one hydroxyl group is alkylated with lower alkyl having no more than 5 carbon atoms.

8. The method of claim 4 wherein the bridge A in the iodo compound is a member selected from the group consisting of CH .CH(OH) .CH .O.(CH .O.CH .CH(OH).

and the aforesaid bridges in which at least one hydroxyl group is acylated with lower acyl having no more than 5 carbon atoms.

9. A method for the X-ray visualization of body cavities, which comprises administering to the body of the test object as a contrast-producing agent a preparation comprising at least one member selected from the group consisting of (1) iodo compounds of the formula of the iodo compound is situated at a distance of two carbon atoms from a group O--R and wherein not more than one oxygen atom is bound to one and the same carbon atom in the bridge A.

11. The method of claim 9, wherein the bridge A in the iodo compound is a member selected from the group consisting of and the aforementioned bridges in which at least one hydroxyl group is alkylated with lower alkyl having no more than 5 carbon atoms.

12. The method of claim 9, wherein the bridge A in the iodo compound is a member selected from the group consisting of and the aforementioned bridges in which at least one hydroxyl group is acylated with lower acyl having no more than 5 carbon atoms.

13. The method of claim 9, wherein the substituents R R in the iodo compound are each a member selected from the group consisting of acetyl; propionyl and butyryl and R is a member selected from the group consisting of hydrogen; methyl; ethyl; acetyl; and propionyl.

14. A method for the X-ray visualization of body cavities, which comprises administering to the body of the test object as a contrast-producing agent a preparation comprising at least one member selected from the group consisting of (1) iodo compounds of the formula COOH COOH wherein R -R are each lower acyl having no more than 5 carbon atoms and wherein A is an alkylene group substituted by at least one substituent of the formula -OR, wherein R is a member selected from the group consisting of hydrogen; lower alkyl and acyl having no more than 5 carbon atoms, said alkylene group containing 3-10 carbon atoms and being broken by at least one oxygen bridge, and (2) physiologically acceptable salts thereof; said preparation being administered in an amount effective to give a suflicient contrast effect.

15. The method of claim 14, wherein each nitrogen atom in the bridge of the iodo compound is situated at a distance of two carbon atoms from a group --OR, and wherein not more than one oxygen atom is bound to one and the same carbon atom in the bridge A.

16. The method of claim 14, wherein the substituents R R in the iodo compound are each a member selected from the group consisting of acetyl; propionyl; and butyryl and R is a member selected from the group consisting of hydrogen, mthyl, ethyl, acetyl and propionyl.

17. A preparation for carrying out the X-ray visualization of body cavities by being administered to the body of the test object as a contrast-producing agent a mixture which comprises an aqueous solution comprising water and at least one member selected from the group consisting of (1) iodo compounds of the formula I 1 R1 R; R; o 1 14 H. N.C C.NAN.C (5.1m 1.0 0.1 1.0 0.x V i 1 00011 00011 wherein R -R are each lower acyl having no more than 5 carbon atoms and wherein A is an alkylene group substituted by at least one substituent of the formula -O-R, wherein R is a member selected from the group consisting of hydrogen; lower alkyl and acyl having no more than 5 carbon atoms, said alkylene group containing 320 carbon atoms, and (2) physiologically acceptable salts thereof; and wherein said at least one member is present in an effective contrast-producing amount.

18. The preparation of claim 17, wherein said mixture is an aqueous solution for injection purpose and oral use; and wherein said at least one member is present in an amount equal to about 10 to 50 grams per ml. of

the preparation.

19. The preparation of claim 17 wherein said alkylene group contains 3-10 carbon atoms.

20. The preparation of claim 19 wherein said mixture is an aqueous solution for injection purpose and oral use; and wherein said at least one member is present in an amount equal to about 10 to 50 grams per 100 ml. of the preparation.

21. A preparation for carrying out the X-ray visualization of body cavities by being administered to the body of the test object as a contrast-producing agent a mixture which comprises an aqueous solution comprising water and at least one member selected from the group consisting of (1) iodo compounds of the formula wherein R R are each lower acyl having no more than 5 carbon atoms and wherein A is an alkylene group substituted by at least one substituent of the formula -OR, wherein R is a member selected from the group consisting of hydrogen; lower alkyl and acyl having no more than 5 carbon atoms, said alkylene group containing 3-20 carbon atoms and being broken by at least one oxygen bridge, and (2) physiologically acceptable salts thereof; and wherein said at least one member is present in an effective contrast-producing amount.

22. The preparation of claim 21 wherein said mixture is an aqueous solution for injection purpose and oral use; and wherein said at least one member is present in an amount equal to about 10 to 50 grams per 100 ml. of the preparation.

23. The preparation of claim 21 wherein said alkylene group contains 3-10 carbon atoms.

24. The preparation of claim 23 wherein said mixture is an aqueous solution for injection purpose and oral use; and wherein said at least one member is present in an amount equal to about 10 to 50 grams per 100 ml. of the preparation.

References Cited UNITED STATES PATENTS 2,776,241 1/ 1957 Priewe et al. 424-5 3,178,473 4/1965 Holtermann et al. 4245 3,290,366 12/1966 Hoey 4245 3,306,927 2/1967 Larsen 425-5 ALBERT T. MEYERS, Primary Examiner F. E. WADDELL, Assistant Examiner US. Cl. X.R. 2605 19 

